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Lead wipe sample chain of custody form, March 2003

Machine-extracted title · confidence 95%

Chain of custody form documenting the collection and transfer of lead wipe samples from 100 Church Street to a laboratory.

NYC-WTC_000174632
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Scanned page image, NYC-WTC_000174632
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OCR status: ok · source: pdftotext

NYC 9/11 Public Portal Document

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TOC LEAD WIPE SAMPLE DATA AND CHAIN OF CUSTODY FORM •

l‘ 13

Page; Clieni Nev/ York City Law Deparfirent Project Name i Address: 100 Church St. IRC Field Representahve: Zibby Doltnski i of 1 !5 1 ’3 » C

Date; 03/22/03 Requested Turnaround Time: IRC Project Manager; NITIN DAVE TRC project No: rH 12Hrs OFFICE PHONE: (212) 221-7822 35052-0000-00017 ‘c CELL PHONE; (917) 549-1382 cr WIPE SAWPLE INFORMATtON __________________ Sample Location_______________________________ Area Sampled Tote! Area Sample Nurnbe r. Surface Descriplion. inches <Sqtn) Floor ______________________ Room/Aiea Deaciipiion____________________ r flcsof^ Li ZD032203LW20ai 12X 12 144 20“' Floor aI \ tj J? d3Cr>^ u 7D032203LW2O02 12X 12 144 20*” Floor up- W-/^ a vvzz^-i> c ozv^-izirc rta4 'rc:'iP=* -t-r- 2D03220.3LW2003 12X12 144 20’” Flooi- a> P P"i /i e^<s> 2D032203LW2O04 12X12 144 20“’ Floor Zv/(>=^-i' ZD032203LW20O5 12X 12 144 20”' Floor w/xju p/i'^ // o -fco-

2D032203LWFB01 Field Slant; s I □C 'Si £ C3

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H SPECIAL INSTRUCTIONS TO LABORATORY k; I Fax Results To (Name) NITIN DAVE al (Number) (21?) 221-7840 h-* s o CHAIN OF CUSTODY DOCUMENTATION AND LABORATORY INFORWATtON Reiinqulshed fiy Time 1- Comnwnls(Lab) j>c> Azor A/YzlZ-ZZ£?■ XJrf^/yfc Dale Received By Dale Time Method of Submillal Ffald TT EMSL I. Zibhy Dofinski 03/22/03 - EPAMETHOD 30500420 Walk In Analysis for Lend only t tn if. US Mail U Name and Stgrtatuie; —> Dale Time I g Un 00 FO Fed-Ex n An.^ed O> FO ill. Olfier u Analyzed Dy: i IIO QC By: CD ro

NYC-WTC_000174632

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NYC-WTC_000174632Source: NYC Law Department, mirrored locally

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